Joe Irvin, PTA
Individual provider Active NPI Specialist · Highland, AR
NPI 1689798191 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1689798191
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- PTA 2000 (AR)
- Practice address
- 1441 Highway 62 412
Highland, AR 72542-9497 - Phone
- (870) 856-9675
- Fax
- (870) 856-9679
- NPI assigned
- Mar 19, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA 2000 | AR | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physical Therapy Works, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | PTA 2000 | AR | Yes |
Addresses
Primary practice location
1441 Highway 62 412
Highland, AR 72542-9497
Mailing address
1441 Highway 62 412
Highland, AR 72542-9497
Phone (870) 856-9675
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PTA 2000 | Other | AR | LICENSE |
Other providers in Highland, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.